Electromyographic pelvic floor activity: Is there impact during the female life cycle?

AIM: To evaluate the pelvic floor muscle (PFM) electromyographic activity in different phases of the female life cycle, correlating electromyographic activity with age, Body Mass Index (BMI), parity as well as the presence and severity of urinary symptoms. METHODS: A clinical, observational, transversal and controlled study was conducted in 384 women: 49 nulliparous, 103 primigravid pregnant, 92 primiparous postpartum (vaginal delivery: n = 43; cesarean section delivery: n = 49), 22 climacteric, 65 postmenopausal, and 53 women identified as being unable to perform voluntary maximum contraction. All subjects were evaluated with digital palpation and PFM surface electromyography (sEMG) and completed the questionnaires: International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ IU-SF) and International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB). Spearman's Correlation Coefficient and ANOVA were used to analyze the variables. RESULTS: The nulliparous women had higher PFM electromyographic activity than the other groups. The primigravid pregnant, cesarean section and vaginal delivery groups had higher electromyographic activity than the postmenopausal group. Studying PFM electromyographic activity with the factors evaluated, a negative correlation between age, parity, and the presence and severity of urinary symptoms was observed. There was no correlation between PFM electromyographic activity and BMI. CONCLUSION: Fourteen percent of women participating were not able to perform active contraction of the PFM. PFM electromyographic activity changed during the female life cycle. PFM electromyographic activity correlated inversely with age, parity, and the presence and severity of urinary symptoms.

A pelvic floor muscle training program in postmenopausal women: A randomized controlled trial.

OBJECTIVES: The purpose of this study was to investigate if a specific pelvic floor muscle training (PFMT) program effectively increases pelvic floor muscle (PFM) contractility and decreases anterior pelvic organ prolapse (POP) as well as urogynecological symptoms, in postmenopausal women. The mean outcome measure of this study was the pelvic floor surface electromyography (sEMG) activity. STUDY DESIGN: A clinical, randomized, blinded-assessor and controlled study was conducted with 46 postmenopausal women. Thirty women completed this study (mean age of 65.93 years), divided into two groups: Treatment Group - TG (n=18) and Control Group - CG (n=12). The evaluation was carried out using digital palpation, sEMG, pelvic organ prolapse quantification (POP-Q) as well as validated questionnaires by the International Consultation on Incontinence Questionnaires to investigate urogynecological symptoms. The treatment protocol consisted of 12 group sessions, twice a week, with 30 min of duration each. These data were then submitted to statistical analyses by the Statistical Analysis System for Windows software, with a significance level of 5%. RESULTS: The pelvic floor muscle contractility increased after PFMT, evaluated by sEMG (p=0.003) and digital palpation (p=0.001), accompanied by a decrease in urinary symptoms (p<0.001 for ICIQ-OAB scores e 0.036 for ICIQ UI-SF) as well as anterior pelvic organ prolapse (p=0.03). CONCLUSION: This preliminary study suggests that the applied PFMT program could be an effective way to increase PFM contractility, as well as to decrease both anterior pelvic organ prolapse and urinary symptoms, in postmenopausal women.